Impact100 DC · Application for Impact100 DC Fellowship -- First Year Application

One moment please...

Application for Impact100 DC Fellowship -- First Year Application

Impact100 DC’s Fellowship program is designed to provide a path to membership for women who want to make an active contribution and need financial assistance in order to join.

Contact Information

Name

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Date of Birth

(mm/dd/yyyy)

Occupation

Organization/Employer

Why are you interested in joining Impact100 DC?

In what aspects of the Impact DC would you like to participate?

What skills/expertise/experience would you bring to your participation?

I understand that receipt of an Impact DC fellowship commits me to active participation in the work of the organization.